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General NPI Number Information
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NPI Number | 1275496846
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Entity Type | Organization
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Legal Business Name | IDEAL COMMUNITY LIVING 2 LLC
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Dates
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Enumeration Date | 12/09/2025
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Last Update Date | 12/14/2025
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Provider Practice Location Address
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Address Line | 3900 W BROWN DEER RD STE C6
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City | BROWN DEER
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State | WI
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Zip | 53209-1220
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Country | US
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Telephone | 262-469-1053
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1111
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City | WEST BEND
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State | WI
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Zip | 53095-8611
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Country | US
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Telephone | 262-469-1053
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DANA CATRICE PERRY
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Credential |
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Telephone | 262-469-1053
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QI0500X
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Taxonomy Name | Infusion Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2081P0004X
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Taxonomy Name | Spinal Cord Injury Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 221700000X
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Taxonomy Name | Art Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 224ZF0002X
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Taxonomy Name | Feeding, Eating & Swallowing Occupational Therapy Assistant
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 224Y00000X
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Taxonomy Name | Clinical Exercise Physiologist
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 163WC3500X
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Taxonomy Name | Cardiac Rehabilitation Registered Nurse
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 171R00000X
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Taxonomy Name | Interpreter
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 103TR0400X
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Taxonomy Name | Rehabilitation Psychologist
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 163WM1400X
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Taxonomy Name | Nurse Massage Therapist (NMT)
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License Number |
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License Number State |
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Taxonomy #12
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Taxonomy Code | 2279G1100X
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Taxonomy Name | General Care Registered Respiratory Therapist
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License Number |
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License Number State |
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Taxonomy #13
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Taxonomy Code | 152WP0200X
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Taxonomy Name | Pediatric Optometrist
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License Number |
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License Number State |
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Taxonomy #14
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Taxonomy Code | 364SR0400X
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Taxonomy Name | Rehabilitation Clinical Nurse Specialist
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License Number |
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License Number State |
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Taxonomy #15
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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